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General NPI Number Information
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NPI Number | 1790343903
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Entity Type | Organization
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Legal Business Name | MICHAEL C WHITE DC PA
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 06/03/2019
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Provider Practice Location Address
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Address Line | 14645 NW 77TH AVE STE 107
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2569
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Country | US
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Telephone | 305-570-1965
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Fax | 305-570-1968
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Provider Business Mailing Address
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Address Line | 14645 NW 77TH AVE STE 107
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City | MIAMI LAKES
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State | FL
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Zip | 33014-2569
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Country | US
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Telephone | 305-570-1965
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Fax | 305-570-1968
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MICHAEL CORWIN WHITE
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Credential | DC
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Telephone | 561-352-7893
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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